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Volume 17, Number 12—December 2011

Knowledge of Avian Influenza (H5N1) among Poultry Workers, Hong Kong, China

Jean H. Kim, Fung Kuk LoComments to Author , Ka Kin Cheuk, Ming Sum Kwong, William B. Goggins, Yan Shan Cai, Shui Shan Lee, and Sian Griffiths
Author affiliations: The Chinese University of Hong Kong, Hong Kong, People’s Republic of China (J.H. Kim, F.K. Lo, M.S. Kwong, W.B. Goggins, Y.S. Cai, S.S. Lee, S. Griffiths); University of Oxford, Oxford, UK (K.K. Cheuk)

Main Article

Table A1

Responses to questionnaire Items related to knowledge and preventive practices for avian influenza (H5N1) for 360 poultry workers, Hong Kong, China*

Item† Value
Virus can infect
Wild birds? [Y] / Live poultry [Y] / Domestic birds? [Y] 65.4/60.1/44.8
Humans? [Y] / Other animals? [Y] 50.0/17.0
Virus can be transmitted from 1 place to another on
Bird feces? [Y] / Poultry cages? [Y] / Bird feed? [Y] / Clothing and shoes? [Y] 82.7/26.8/16.9/11.9
Humans can be infected by
Eating behavior: eating poultry cooked well done? [N] / Eating runny eggs? [Y] 69.1/14.0
Infected bird contact: bird feces? [Y] / Breathing near birds? [Y] / Swimming with birds? [Y] 59.7/22.1/19.4
Occupational risks: slaughtering poultry? [Y] / Defeathering poultry? [Y] 29.1/14.9
Symptoms of infection in humans
Dermatologic: Hair loss? [N] / Rash? [N] 99.4/98.2
Influenza-like: Fever? [Y] / Cough? [Y] / Muscle pain? [Y] / Runny nose? [Y] 89.8/67.1/67.1/54.5
Respiratory: Difficulty in breathing? [Y] / Crackling breathing sounds? [Y] 59.2/18.8
Other: Vomiting? [Y] / Diarrhea? [Y] / Nose bleeding? [Y] 25.0/14.3/2.9
There have been reported human cases
Somewhere? [Y] / Asia? [Y] / People’s Republic of China? [Y] / Hong Kong? [Y] 96.8/91.1/78.2/72.6
100% effective, commercially available vaccines exists
For birds? [N] / For humans? [N] 80.2/67.2
Duration virus can survive outside body
<6 h / 6h– 24h / several days / [>1 wk] 29.0/22.7/18.0/30.3
Mortality rate for humans
Almost everyone survives / <50% / [50%–89% die] / >90% / don’t know 57.9/26.3/13.5/1.2/1.2
Overall knowledge score, range 0–36, mean, SD 6.7, 6.43
Knowledge score multivariable linear regression model, β (95% CI), p value‡§
Educational level, primary or less = referent, F1–3, >F4 0.97 (0.07–1.87), 0.035
Household monthly income >20,000 Hong Kong dollars 1.61 (0.09–3.13), 0.038
Received prevention information from the Internet 4.35 (2.58–6.13), <0.0001
Received prevention information from other sources¶ 3.86 (1.10–6.62), 0.006
In the past month, how frequently did you? Almost always / Sometimes? / Never?
Handle live chickens with bare hands 37.5/27.5/35.0
Handle dead chickens with bare hands 10.3/27.4/62.3
Wear eye protection when handling chickens 7.3/22.3/70.4
Wear face mask when handling chickens 25.3/35.2/39.5
Wear PPE (e.g., apron, mask) when handling chickens 51.2/22.4/26.4
Sterilize your clothes 52.9/31.8/15.3
Wash hands with soap after killing chickens 65.2/24.6/10.2
Overall preventive practice score, mean ± SD (range)# 8.16 ± 3.26 (0–14)
Practice score multivariable linear regression model, β (95% CI), p value‡**
>10 y working in the poultry industry; <10 y is referent 1.45 (0.39–2.51), 0.010
Retail shop worker; wholesale is referent 1.11(0.08–2.14), 0.034
Below median perceived barriers score; above median is referent 1.44 (0.43–2.46), 0.006

*Values are % responding correctly unless otherwise indicated. Y, yes; N, no; PPE, personal protection equipment; CI, confidence interval.
†Correct answers are indicated in [brackets].
‡Variance inflation factors (VIF) diagnostics indicated no evidence of colinearity (all VIF <1.2) among variables in final models. Model fit analysis showed that standardized residuals of models were normally distributed and not associated with standardized predicted values.
§Final model constant for knowledge score, α (95% CI) 13.70 (11.8–15.6). The following candidate covariates had the following β coefficients and p values before removal from knowledge score model: age, β = 0.25, p = 0.57; <10 years in poultry industry, β = 1.08, p = 0.20; newspaper information source, β = 0.79, p = 0.284; health workers information source, β = −1.06, p = 0.441; poster information source, β = −0.04, p = 0.650.
¶Other health information sources included health talks, seminars, school, radio, flyers, and other poultry workers.
#Scored 2 = always, 1 = sometimes, 0 = never for computing summative score. Items 1 and 2 about chickens are reverse coded.
**Final model constant for practice score, α (95% CI) 6.18 (5.08–7.29). The following candidate covariates had the following β coefficients and p values before removal from practice score model: monthly income >20,000 Hong Kong dollars, β = −0.036, p = 0.956; above median avian influenza (H5N1) susceptibility score, β = 0.171, p = 0.797; above median avian influenza (H5N1) perceived severity score, β = −0.965, p = 0.143.

Main Article

Medline reports the first author should be "Olsen SJ" not "Olsen S" in reference 10 "Olsen, Laosiritaworn, Pattanasin, Prapasiri, Dowel, 2005".

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